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dbybee

Tendonitis In Thumbs

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I am having problems with tendonitis at the base of my thumbs, at the upper wrist, on both sides. Left side is the worse, but it also exists in the right side. I played a rental 20 button for the first 12 months with no problems, but once I switched to a new 30 button, my problems cropped up within about 7 weeks. This has been going on since the beginning of February, but only recently was I referred to an Orthapedist. I am now in two very rigid wrist and thumb braces till June 1. Then if healed, I will start physical therapy. My Orthopedist thinks it is from my hand postion while playing. I did have a little numbness in my left thumb after a couple of fast practice sessions, but nothing obvious that would have caused it.

 

I thought I saw an article with pictures of a modified wood hand rest that provides full support for the palm, and a straight wrist. I can no longer find this article through many searches and browsing. Doc thinks my wrist should be straighter, and that I should not hook my thumbs over the end of the hand rest. I saw the article on using the foam pipe insulation to build up the rest, but I think the wood rest created more support at the base of the palm. I have a modified thumb rest in mind that would keep the thumb from hooking, plus I will need to concentrate on not bearing down so hard, with my thumbs, when I play.

 

It is very frustrating not being able to play, as well as all of the other things you do not realize you need your wrists for. I was really beginning to have fun. I had just started to play with an ensemble of diatonic instruments, and have been performing in Old Sacramento on the streets and during Gold Rush Days, dressed as an 1850s miner.

 

If any one can direct me to the article or a source for hand rest modifications I would appreciate it. Otherwise, I guess I am just feeling a little sorry for myself and doing a little whinning.

 

Donald Bybee

Sacramento, California

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If you are talking about my article, you can find it (and most anything here) one of two ways.

 

Look on the long list of articles by topic down the left side of the the Home page.

 

Or, go to (in this case) to the Learning Page.

 

In both places, you will find references to

Ken's experience

and

The foam handle article.

 

The Learning page points to other articles on ergonomics. This is very individual, and your situation is undoubtedly unique in some way. The point is to experiment, with that expert advice you now have.

 

Since writing the article, I have turned the foam pads over, so that they are wider near my smallest finger, moving it closer to the buttons. I've also made them longer, with a slot to go around the leather strap. This keeps them from falling out quite so often. If i had a digital camera I would add a photo so you could see what I mean.

 

For everyone else, I should note that we are now vigilant about making sure all articles here are linked, preferably both from the home page and the relevant area page, once they have fallen off the news items list on the right side of the home page. Do take time to explore -- there is a lot here besides the forum system.

 

Ken

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If any one can direct me to the article or a source for hand rest modifications I would appreciate it.

The Topic Modified Handle.anglo includes some diagrams for Göran Rahm's modification. There are also some discussion and additional diagrams in the Topic Reforming Concertina(s), Drawings of hybride layout. Further details can be found in Göran's writings, which Chris Timson has kindly provided space for on his own web site. Göran's article An Ergonomic Handle For English, Anglo And Duet Concertinas, on the other hand, is mainly a statement of his reaons for his design, rather than details of how to implement it.

 

While I personally disagree with Göran's claims for the universal superiority of his design, it does sound like you might find it helpful. If you would like to communicate with him personally via email, let me know, and I'll ask him to contact you.

 

Also, I thought there were some photos of his handle/support available, but right now I can't locate any. If I do, I'll let you know.

 

Michael Bell has also built roughly similar -- though much taller -- supports for his English concertina, as described and pictured in his article A New Design of Handle for The Concertina.

 

Edited to correct my grammar.

Edited by JimLucas

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I am having problems with tendonitis at the base of my thumbs, at the upper wrist, on both sides....

My Orthopedist thinks it is from my hand postion while playing.  I did have a little numbness in my left thumb after a couple of fast practice sessions, but nothing obvious that would have caused it. 

It seem to me that the way you hold your concertina is what has caused your tendonitis. You mention "hooking your thumbs over the end of the hand rest" which is something I find very few people do, and them only *very* rarely, and then only to play with the instrument unsupported (in the air).

 

How do you normally play your concertina? The "fix" may be a simple as playing it on your thigh like most people do.

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I played a rental 20 button for the first 12 months with no problems, but once I switched to a new 30 button, my problems cropped up within about 7 weeks. 

What kind of 20-button, and what kind of 30-button? The size and shape of the ends, placement of the rails (hand bars) and shape of the straps can constrain the options open to you.

 

It seem to me that the way you hold your concertina is what has caused your tendonitis.

... The "fix" may be a simple as playing it on your thigh like most people do.

I'm sure Rich is right, but the question remains as to why you're gripping with your thumbs. Were you doing that also with the 20-button, or was there something about the shape of the handles on that instrument which prevented it? And the second question is whether you can learn to prevent yourself from gripping like that without artificial aids... at least quickly enough to avoid recurrence of the problem.

 

I can recommend some alternative methods of "gripping" the instrument, but they'll only help if you can learn to do them instead of what you've become accustomed to. One of them, though, is a mechanical training exercise, rather than something I would recommend as a long-term standard for holding the instrument. Otherwise, mechanical aids could help.

 

I'll go into detail in a separate post, but first I would like to hear about your 20- and 30-button instruments. I'm guessing that the 20-button is a clunkly German-style, and the 30-button is constructed -- at least externally -- on the style ofthe English-made anglos. Yes, or no?

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Thanks for all of the input. I quickly glanced through the articles and the one on ergonomic handles is the one I had seen before. When I get more time I will take a closer look at the design and the concept behind it.

 

The instrument I started on was a Stagi B1, 20 button. My new instrument is a 30 button Stagi W-15-LN. I play most of the time while sitting, with both ends of the instrument in my lap. (rest the left and move the bellows with the right.) I sometimes stand when on the street, but put my left leg up and rest the left end of the instrument on my thigh. I initially felt the new instrument was more difficult to brace while playing, partially because the handles are closer to the body side of the instrument. (Not as close to the center of the ends.) I may have picked up the habit of hooking my thumbs and bearing down to help brace the ends. A small wood pad placed on the forward side of the hand rest may be enough to give the thumb a little different position, and help the problem. I also like the look of the smooth wood platform for the hand, in the article's pictures. This looks like it would give better support, keep the wrist straight, and help brace the ends as well.

 

Some of your responses made me realize that before I start modifying the new instrument, I should go back to my shop and compare the new instrument with the old, for differences. Identifying these will be a starting point to determine why one instrument would cause a problem while another would not. (I have been traveling 168 miles round trip every two weeks for lessons, so it is not a quick jont to go check the instrument.)

 

I have until June 1 to think about it. After that the braces come off and I have either healed and start physical therapy, or possibly cortisone injections. I therefore have plenty of time to think about possible fixes to the problem.

 

Thanks again.

 

Donald Bybee

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This evening I finally played my Anglo after some months of recuperation. It feels great to be playing again. I eventually had a cortisone shot in my left wrist, which now, though many weeks later, does not hurt at all. My right wrist is a little sore, but is getting better. I have been away from it for so long, (about 6 months) that it seems like learning all over again. This may be good as it may be easier to break myself of what appeared to be some bad ergonomic playing habits. I am going to experiment with some simple pads to change hand position slightly, and basically take it easy for quite a while.

 

Thanks again for all of your help and support.

 

Donald

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Isn't it true that the strap adjustment can cause these problems as well?

A brand new strap softens and moulds to your hand positiion over the years and may encourage the wrong position.

I tend have my strap slack enough to play bass runs etc. and to very gently press with my thumbs on top of the hand rest to slightly tighten the strap when necessary.

 

Has anyone found whether people who have wrist/hand problems are learning in isolation, without a tutor or fellow players to watch/discuss methods of holding the box or whether some people may have these problems and can't do much about it? Just a thought.

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